Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Germany.
Int Arch Occup Environ Health. 2010 Feb;83(2):183-9. doi: 10.1007/s00420-009-0448-z. Epub 2009 Jul 30.
Occupational skin diseases are a significant public health concern. Little is known about the cognitive representations individuals with occupational skin disease have towards measures of personal skin protection and occupational safety and whether they change during an intervention. We aimed to evaluate whether social cognitions as embodied by the theory of planned behaviour become more favourable during a tertiary inpatient individual prevention programme (TIP) and whether the model's predictions hold in a setting to which the model has not been applied.
We used a longitudinal design. A questionnaire, assessing the theory of planned behaviour variables attitude, subjective and descriptive norm, perceived behavioural control and behavioural intention was developed and administered to 101 patients before (at admission) and after (at discharge) a 3-week inpatient TIP.
The scales showed good internal consistency. Before the TIP, patients had favourable cognitions towards skin protection measures and these improved during the TIP. Attitude, perceived behavioural control and intention to perform skin protection significantly increased during TIP. Attitude and perceived behavioural control were significant predictors of behavioural intention in multiple regression analyses with perceived behavioural control being the strongest predictor in the equations. Descriptive norm was a significant predictor of intention only at admission but not at discharge.
This is the first study attempting to explain the motivation to perform skin protection measures in patients with occupational skin disease by applying an otherwise well established health-behaviour theory. The results emphasise the importance of health-educational and psychological interventions for patients with occupational skin disease. Promoting personal control over and attitudes towards skin protection measures may enhance the occupational health of individuals with occupational skin disease.
职业性皮肤病是一个重大的公共卫生问题。目前人们对患有职业性皮肤病的个体对个人皮肤保护和职业安全措施的认知表现知之甚少，也不知道这些认知表现是否会在干预过程中发生变化。我们旨在评估在三级住院个体预防计划（TIP）期间，计划行为理论所体现的社会认知是否会变得更加有利，以及该模型的预测在尚未应用该模型的环境中是否成立。
我们采用了纵向设计。开发并向 101 名患者在 TIP 前（入院时）和 TIP 后（出院时）使用了一份评估计划行为理论变量态度、主观和描述性规范、感知行为控制和行为意向的问卷。
这些量表具有良好的内部一致性。在 TIP 之前，患者对皮肤保护措施有良好的认知，而这些认知在 TIP 期间得到了改善。在 TIP 期间，态度、感知行为控制和皮肤保护行为意向显著增加。在多元回归分析中，态度和感知行为控制是行为意向的显著预测因素，而感知行为控制是方程中的最强预测因素。描述性规范仅在入院时是意向的显著预测因素，但在出院时不是。
这是首次尝试通过应用成熟的健康行为理论来解释职业性皮肤病患者进行皮肤保护措施的动机。研究结果强调了对职业性皮肤病患者进行健康教育和心理干预的重要性。促进对皮肤保护措施的个人控制和态度可能会增强职业性皮肤病患者的职业健康。
